SOUTHERN OREGON MEDICAL PRACTICE LLC NPI 1184000549

NPI Information

NPI: 1184000549
Provider Name: SOUTHERN OREGON MEDICAL PRACTICE LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 38D0932319

Address:
824 UNIT B, ROGUE RIVER HIGHWAY
GRANTS PASS, OR
ZIP 97527
Phone: (541) 244-1261
Get Directions

SOUTHERN OREGON MEDICAL PRACTICE LLC is a family nurse practitioner in Grants Pass, OR. SOUTHERN OREGON MEDICAL PRACTICE LLC NPI is 1184000549. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

824 UNIT B, ROGUE RIVER HIGHWAY
GRANTS PASS, OR
ZIP 97527-000
Phone: (541) 244-1261
Fax: (541) 295-8252

The provider's authorized official is Stephen Daniel Spalletta .
The authorized official title is Owner and has the following contact phone number (541) 295-4034.

The CLIA number assigned to this NPI record is 38D0932319 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/7/2015 and was last updated on 8/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	1174571186	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »